In patients with severe symptomatic aortic valve stenosis (AVS), surgical aortic valve replacement (SAVR) is known to reduce morbidity and mortality. However, the efficacy of SAVR has not been clearly established. This study aims to evaluate the efficacy of SAVR, including frequency of survival, stroke, atrial fibrillation, structural valve deterioration, and length of the hospital in patients with severe symptomatic AVS.
This was a systematic review and meta-analysis of observational studies that followed patients after SAVR with a bioprosthetic valve. The researchers utilized the GRADE system to quantify absolute effects and quality of evidence. The primary outcomes of the study were survival and freedom from AVS.
During a minimum follow-up of 2 years, patients undergoing SAVR with a bioprosthetic valve had a median survival of 16 years for those aged 65 years or less, 12 years for those aged 65-75 years, 7 years for those aged 75-85 years, and 6 years for those aged 85 or more. The incident rate was 0.25 per 100 person-years for stroke and 2.9 per 100 person-years for atrial fibrillation.
The research concluded that in patients with severe symptomatic AVS undergoing SAVR with a bioprosthetic valve, the survival rate was slightly lower than those without AVS. The overall survival was inversely proportional to the age of the patient.
Ref: https://www.bmj.com/content/354/bmj.i5065
